ESIS Senior Claims Assistant

About the role

The Claims Assistant provides critical administrative and operational support for the Workers’ Compensation and Risk Management team at the Mashantucket Pequot Tribal Nation/Foxwoods Casino. This role is responsible for intake coordination, document management, and customer service, ensuring efficient claims processing and compliance with Tribal and regulatory requirements.

Responsibilities

• Greet visitors, answer the door, and direct individuals to ESIS, Risk Management, Onsite Clinic, Physical Therapy, or HR Benefits offices.
• Screen newly injured employees and coordinate intake, determining assignment to adjuster or Medical Only.
• Contact departments to confirm light duty accommodations for employees.
• As Light Duty Coordinator: Meet with injured employees to review program and assign suitable light duty jobs based on restrictions. Escort employees to assigned positions and maintain ongoing communication to ensure compliance.
• Track and submit weekly time sheets for light duty employees to payroll.
• Authorize prescriptions with Tribal Pharmacy for injured employees as directed by the Onsite Clinic.
• Meet daily with Clinical Coordinator to review and follow up on physical therapy, MRI, and care transfer authorizations.
• Cooky with One Call Medical for MRI/EMG requests on claims.
• Coordinate with One Call Medical for MRI/EMG requests on claims.
• Index and manage daily medical reports.
• Complete and distribute First Report of Injury forms, maintaining records for OSHA log completion.
• Scan, index, and organize medical and therapy reports, ensuring timely correspondence in WorkView system.
• Process and pay American Ambulance and Tribal Pharmacy bills locally, including monthly report indexing and scanning.
• Index hearing dockets, prepare files for hearings, and print necessary documents.
• Register all claims and complete clerical instructions assigned.
• Perform mailroom duties, including postage, opening, and indexing mail.

Qualifications

• High school diploma or equivalent required; associate’s degree preferred.
• Prior experience in claims, risk management, or medical office administration strongly preferred.
• Strong organizational skills and attention to detail.
• Excellent communication and customer service skills.
• Proficiency with document management systems and Microsoft Office Suite.
• Ability to handle confidential information with discretion.